REGENERATIVE MEDICINE TO ENHANCE ORTHOPEDIC SURGICAL OUTCOMES

September 25, 2016

Regenerative adjunctive treatment is the next logical step in the progression of surgical intervention. The new

paradigm shift in stem cell research has been reflected in the field of or thopaedic indications with limited therapeutic approach which could be benefited using cellular therapy. The relative lack of blood supply as compared with other tissues make these structures incapable of quick healing like other body organs. Consequently, chronicity tends to become a hallmark of musculoskeletal injuries. Clinical use of stem cells have been used in cases of non-unions, avas- cular necrosis (AVN), spinal fusions, bone defects, tendon healing and cartilage repair etc.

Bone is an excellent tissue and the natural tendency of bone when fractured is to unite by forming bone. Non-union results from a gap at the fracture site resulting from bone loss. Non/delayed unions occur in approximately 5-20% of fractures and despite their regular occurrence, management remains challenging. They are defined as non-bridged areas after 6 months of periosteal and endosteal healing and results in severe functional impairment. The most common method to treat non-union has been bone grafting to provide osteo-inductive, osteo-conductive substrates and to supply osteo-progenitor cells. Bone grafting is considered as the gold standard procedure for non-unions. However, the autogenous bone grafting technique tends to produce donor site morbidity and use of allograft has the tendency to pro- duce immunological reaction. Several studies have shown a promising effect of autologous bone marrow mononuclear